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Therapeutic indications of Laparoscopy in gynecology are all except
|
All of the options are therapeutic indications of Laparoscopy.
| 4 |
Vault prolapse
|
Septate uterus
|
Gamete intrafallopian transfer
|
None of the above
|
Gynaecology & Obstetrics
| null |
8b2bd963-c517-43bc-82d6-1bd5ed9a2131
|
multi
|
Which of the follwing patients is most likely to be treated with intravenous glucagon?
|
(Ref: KDT 6/e p274) Glucagon is the antidote of b-blocker poisoning. It acts by increasing cAMP in the hea stimulation of glucagon receptors. Cyclic AMP stinulates the hea. Calcium gluconate can also be used for the treatment of b-blocker poisoning.
| 3 |
A young man who took cocaine and has a blood pressure of 190/110 mm Hg
|
A middle aged man with type II diabetes who has not taken his regular dose of glipizide for last 4 days
|
An old man with severe bradycardia and hypotension resulting from ingestion of overdose of atenolol
|
An old woman with lactic acidosis as a complication of severe infection and shock
|
Anatomy
|
Other topics and Adverse effects
|
9c67acc7-bfc0-4db1-bb3a-016f960d3c30
|
single
|
Clinical findings suggestive of adequacy of pelvis for vaginal delivery are all except?
|
Ans. is 'b' i.e., Interspinous diameter > 8 cmClinical findings suggestive of adequacy of pelvis for vaginal delivery are:Findings indicating adequate pelvisForepelvis (pelvic brim)RoundDiagonal conjugate11.5 cmSymphysisAverage thickness, parallel to sacrumSacrumHollow, average inclinationSide wallsStraightIschial spinesBluntInterspinous diameter10.0 cmSacrosciatic notch2.5-3 finger - breathsBituberous diameter4 knuckles (> 8.0 cm)CoccyxMobileAnterposterior diameter of outlet11.0 cm
| 2 |
Diagonal conjugate > 11.5 cm
|
Interspinous diameter > 8 cm
|
Sacrosciatic notch 2.5 - 3 finger breadths
|
Bituberous diameter > 8 cm
|
Gynaecology & Obstetrics
| null |
e66b836f-18bd-4821-be55-22046bf38e66
|
multi
|
All of the following is an example of squamous metaplasia except:
|
In Barrett esophagus, in which the esophageal squamous epithelium is replaced by intestinal-like columnar cells under the influence of refluxed gastric acid. Options analysis Cervix in case of chronic irritation show squamous metaplasia The most common epithelial metaplasia is columnar to squamous as occurs in the respiratory tract in response to chronic irritation. Stones in the excretory ducts of the salivary glands, pancreas, or bile ducts, which are normally lined by secretory columnar epithelium, may also lead to squamous metaplasia
| 4 |
Cervix in case of chronic irritation
|
Respiratory tract in case of smoking
|
Stone in bile ducts
|
Esophagus in gastric reflux
|
Pathology
|
General Concepts
|
91ba8dfb-2792-4c2d-aa58-523f9948121e
|
multi
|
A farmer working in the sugar cane industry comes to you for advice on how to prevent fungal infection (bagassosis) of the lung. His elder brother was diagnosed to have bagassosis 1 month ago. You would advise him to spray the sugar cane with which of the following?
|
Bagassosis is caused due to thermoactinomyces sacchari. The preventive measures include dust control, personal protection using masks etc. Pre Placement medical assessment followed by periodical medical check up and spraying the bagasse with 2% propionic acid. Keeping the humidity over 20% is also helpful. Ref: Park, Edition 21, Page - 747, 748
| 3 |
2% formic acid
|
2% acetic acid
|
2% propionic acid
|
10% hypochlorite solution
|
Social & Preventive Medicine
| null |
be6d7c9b-c11a-4f96-baf7-6c8ec864859b
|
single
|
The ovoviviparous nematode is -
| null | 3 |
Ascaris lumbricoides
|
Dracunculus medinensis
|
Strongyloides stercoralis
|
Enterobius vermicularis
|
Microbiology
| null |
624eabda-fad5-4cf9-b1b6-f2de0e113108
|
single
|
For obesity BMI should be:-
|
park25th edition pageno:-428 classification BMI RISK OF COMORBIDITIES UNDERWEIGHT <18.5 LOW NORMAL RANGE 18.5-24.99 AVERAGE OVERWEIGHT: >25.00 Pre- obese 25.00-29.99 INCREASED Obese class 1 30.00-34.99 MODERATE Obese class 2 35.00-39.99 SEVERE Obese class 3 >40.00 VERY SEVERE
| 4 |
>=20
|
>=40
|
>=50
|
>=30
|
Social & Preventive Medicine
|
Non communicable diseases
|
f1d3e6c0-4bca-4871-8a2d-511d6388b07e
|
single
|
Alloyed form of direct gold restoration is:
| null | 3 |
Goldent
|
Mat gold
|
Electralloy
|
laminated gold foil
|
Dental
| null |
9e2ce523-b8f5-4a0b-8b9f-7c8fc2c0269d
|
multi
|
All the following are used in a patient with decreased renal function (reduced GFR) in order to avoid contrast nephropathy except
|
.
| 2 |
N-acetyl cysteine
|
Mannitol
|
Fenoldopam
|
Low osmolar contrast media (LOCM)
|
Medicine
|
All India exam
|
65559d27-f1a0-4efa-8b4f-809a64beeec8
|
multi
|
A chronic alcoholic develops palpitations suddenly after alcohol binge. His pulse is irregularly irregular Which of the following arrythmia is most commonly associated with alcohol binge in the alcoholics ?
|
Atrial fibrillation (AF or A-fib) is an abnormal hea rhythm characterized by rapid and irregular beating of the atrial chambers of the hea. Often it stas as brief periods of abnormal beating which become longer and possibly constant over time.Often episodes have no symptoms. Occasionally there may be hea palpitations, fainting, lightheadedness, shoness of breath, or chest pain.The disease is associated with an increased risk of hea failure, dementia, and stroke. It is a type of supraventricular tachycardia Leads V4 and V5 of an electrocardiogram showing atrial fibrillation with somewhat irregular intervals between hea beats, no P waves, and a hea rate of about 150 BPM. High blood pressure and valvular hea disease are the most common alterable risk factors for AF. Other hea-related risk factors include hea failure, coronary aery disease, cardiomyopathy, and congenital hea disease. In the developing world valvular hea disease often occurs as a result of rheumatic fever. Lung-related risk factors include COPD, obesity, and sleep apnea.Other factors include excess alcohol intake, tobacco smoking, diabetes mellitus, and thyrotoxicosis. However, half of cases are not associated with any of these risks.A diagnosis is made by feeling the pulse and may be confirmed using an electrocardiogram (ECG).A typical ECG in AF shows no P waves and an irregular ventricular rate Ref Harrison 20th edition pg 1456
| 4 |
Ventricular fibrillations
|
Vetricular premature contractions
|
Atrial flutter
|
Atrial fibrillation
|
Medicine
|
C.V.S
|
797d94e2-f414-44f6-ae32-dc61e2b1c172
|
single
|
Treatment of papillary carcinoma thyroid with level VI lymph
node metastasis is
|
IF level VI is affected then CND is done. If any other LN is involved then modified radical neck dissection is preferred.
| 2 |
Total thyroidectomy
|
Total thyroidectomy + central neck dissection
|
Total thyroidectomy + radioiodine ablation
|
Total thyroidectomy + radical neck dissection
|
Surgery
| null |
b44a245c-1999-4d0b-9d5a-d7666b5386ef
|
single
|
Shortest acting Mydriatic and Cycloplegic is
|
Shortest acting Mydriatic and Cycloplegic is Tropicamide.
Phenylephrine is only mydriatic with no cycloplegic property.
| 3 |
Atropine
|
Phenylephrine
|
Tropicamide
|
Homatropine
|
Ophthalmology
| null |
b41511ba-0d61-4f5d-a429-7cc217893f71
|
single
|
Acute flaccid paralysis is repoed in a child aged -
|
- one of the strategy for polio eradication in India is improving surveillance capable of detecting all cases of AFP due to prohibit non polio etiology. - AFP surveillance is done in all children below age of 15 years. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:208,209 <\p>
| 3 |
0-3 years
|
0-5 years
|
0-15
|
0-25 years
|
Social & Preventive Medicine
|
Communicable diseases
|
2220bc6a-5a32-4218-86e5-29feede57da0
|
single
|
Which of the following does not stimulate enterogastric reflex?
|
Enterogastric reflex: signals from the colon and small intestine to inhibit stomach motility and stomach secretion.The types of factors that are continually monitored in the duodenum and can initiate enterogastric inhibitory reflexes include the following:1. Distention of the duodenum2. The presence of any irritation of the duodenal mucosa3. The acidity of the duodenal chyme4. The osmolality of the chyme5. The presence of ceain breakdown products in the chyme, especially breakdown products of proteins and, perhaps to a lesser extent, of fatsRef: Guyton; 13th edition; Chapter 64; Propulsion and Mixing of Food in the Alimentary Tract
| 4 |
Products of protein digestion in the duodenum
|
Duodenal distension
|
H+ ions bathing duodenal mucosa
|
Cholecystokinin
|
Physiology
|
General physiology
|
885bfbf4-5519-4ce9-8205-5762fc925230
|
single
|
Which pa of orbicularis oculi is known as Horner's muscle:
|
Ans. Lacrimal
| 2 |
Orbital
|
Lacrimal
|
Temporal
|
Muller's muscle
|
Ophthalmology
| null |
b6f530fe-e5db-4a7e-a569-ed1d4944ee4c
|
single
|
Thrombotic event is seen in all of the following, except:
|
Primary or idiopathic ITP -Two clinical subtypes: acute and chronic. -Both are autoimmune disorders in which platelet destruction results from the formation of antiplatelet autoantibodies. -Associated with increased bleeding tendency and not thrombosis. PNH The triad of hemolysis, pancytopenia, and thrombosis is unique to this condition. Thrombosis is the leading cause of death. DIC characterized by activation of the coagulation sequence that leads to the formation of microthrombi throughout the microcirculation of the body. Heparin-Induced Thrombocytopenia Two types; Type I thrombocytopenia which occurs rapidly after the onset of therapy, is moderately severe, Type II thrombocytopenia is more severe and occurs 5 to 14 days after initiation of therapy. It can, paradoxically, lead to life-threatening venous and aerial thrombosis. 4T SCORE FOR HIT : Thrombocytopenia Timing Thrombosis Other cause of Thrombocytopenia In HIT antibodies are targeted against PF-4(platelet factor-4).
| 3 |
Paroxysmal nocturnal hemogloninuria
|
Disseminated intravascular coagulation
|
Immune thrombocytopenic purpura
|
Heparin induced thrombocytopenia
|
Pathology
|
Bleeding disorder
|
3b6201fa-84c9-467b-a265-832bf5df87b1
|
multi
|
Maternal Rubella, in newborn causes all Except
|
Rubella - Postnatal infectionComplications of Rubella*Rash spreads from head to torso & extremities.*Forschheimer spots-petechiae haemorrhages on the soft palate.*Rash duration -3 days.*Suboccipital adenopathy.*MC test - IgM Rubella ELISA*Post infectious thrombocytopenia.*Self-limiting small joint ahritis in adults.*Post-infectious acute encephalitis.*Progressive rubella PanencephalitisCongenital Rubella SyndromeTransient signsPermanent signsuBony abnormalitiesuCloudy cornea uHemolytic anaemia uHepatosplenomegaly uJaundice uLow bih weight uLymphadenopathy uMeningoencephalitis uRubella viral pneumonia uThrombocytopenic purpura uAutism uBehavioural disorders uCongenital hea disease uCrytorchidismuDeafnessuDegenerative brain disease uDiabetes Mellitus uGlaucoma uInguinal hernia uMental retardation, Precocious pubey, Microcephaly, Myopia, Retinopathy, Seizures, Spastic diplegia, Thyroid disorders (Refer: Nelson's Textbook of Paediatrics, 19thedition, pg no: Chapter -239)
| 1 |
Neural tube defects
|
CVS defects
|
Cataract
|
Deafness
|
Anatomy
|
All India exam
|
0800aad7-0d48-4d81-b2e8-9d891a91048c
|
multi
|
Eruption of temporary teeth will be completed by :
|
B i.e. 2-21/2 years
| 2 |
One to one and half year
|
Two to two and half year
|
Three to four years
|
Four to five years
|
Forensic Medicine
| null |
2e0cf44a-6ec9-48f0-89b6-331496323052
|
single
|
Substance which binds to substrate other than catalytic enzyme is ?
|
Ans. is 'b' i.e., Non-competitive inhibitor Non-competitive inhibitor In this type of inhibition no competition occurs between substrate and inhibitor. Inhibitor is structurally different from substrate and binds to enzyme at a site other than the substrate binding (catalytic) site. Occupancy of this site by the inhibitor alters the shape of the enzyme such that its catalytic activity is reduced or lost. The substrate is still able to bind the enzyme, but the enzyme cannot catalyze the reaction when inhibitor is bound. Thus, the non-competitive inhibitor does not block the active site of enzyme, but behaves as though it were removing active enzyme from the solution. Evidently, unlike competitive inhibition, increasing the substrate concentration does not reverse the inhibition. Non-competitive inhibition may be reversible or irreversible.
| 2 |
Competitive inhibitor
|
Non-competitive inhibitor
|
Reversible inhibitor
|
None of the above
|
Biochemistry
| null |
48bef5bf-face-4d48-a661-dbe5d61ddea8
|
multi
|
Most common type of monozygotic twin pregnancy at 4th-8th day of cell division
|
In monozygotic twins, chorionicity depends upon time of cell division. Time of cell division Chorionicity of placenta First 72 hours post feilization(morula stage) DCDA 4-8th day(blastocyst stage) MCDA(MC type of monozygotic twins) 8-12th day MCMA >12th day Conjoined/Siamese twins, type of MCMA(fusion of embryonic disc occurs)
| 3 |
Monochorionic Monoamniotic twins with Siamese presentation
|
Monochorionic Monoamniotic(MO-MO) twins
|
Monochorionic Diamniotic twins(MO-DI)
|
Dichorionic Diamniotic twins (DI-DI)
|
Gynaecology & Obstetrics
|
Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)
|
b1b311ba-3c00-42ea-8254-e95817151f7c
|
single
|
Average head circumference at bih is ?
|
O.P. Ghai 9th ed, page 14 Beginning at 34 cm at bih, the head circumference increases approximately 2 cm per month for first 3 months, 1 cm per month from 3-6 months and 0.5 cm per month for rhe rest of the first year of life.
| 1 |
35 cm
|
40 cm
|
45 cm
|
50 cm
|
Anatomy
|
General anatomy
|
b92007f3-02cd-4d4b-bf8b-105469778ae6
|
single
|
Cornea melts without inflammation in which condition -
|
Keratomalacia
It is a common condition in developing countries and is due to deficiency of vitamin A.
The condition is usually bilateral.
In keratomalacia, the cornea becomes dull and insensitive, hazy and yellow infiltrates form until finally the whole tissue undergoes necrosis and seems to melt away within a few hours.
A characteristic feature is the absence of inflammatory reaction.
Keratomalacia is often precipitated by an acute systemic illness such as measles, pneumonia or severe diarrhoea.
| 3 |
Gout
|
Sarcoidosis
|
Keratomalacia
|
Rheumatoid arthritis
|
Ophthalmology
| null |
428da784-4c1e-4200-858c-a0ab6a8d7ba9
|
single
|
Select the drug which is neither analgesic, nor anti- inflammatory, nor uricosuric, but is highly efficacious in acute gout
|
Colchicine Colchicine is neither analgesic nor anti- inflammatory, but it specifically suppresses gouty inflammation. It does not inhibit the synthesis or promote the excretion of uric acid. Thus, it has no effect on blood uric acid levels. pathophysiology of gout:- An acute attack of gout is staed by the precipitation of urate crystals in the synol fluid. On being engulfed by the synol cells, they release mediators and sta an inflammatory response. Chemotactic factors are produced - granulocyte migration into the joint; they phagocytose urate crystals and release a glycoprotein which aggravates the inflammation by: (i) Increasing lactic acid production from inflammatory cells - local pH is reduced - more urate crystals are precipitated in the affected joint. (ii) Releasing lysosomal enzymes which cause joint destruction. mech of action of colchicine:- Colchicine does not affect phagocytosis of urate crystals, but inhibits release of chemotactic factors and of the glycoprotein, thus suppressing the subsequent events. By binding to fibrillar protein tubulin, it inhibits granulocyte migration into the inflamed joint and thus interrupts the vicious cycle Toxicity:- Nausea, vomiting, watery or bloody diarrhoea and abdominal cramps occur as dose limiting adverse effects. Ref:- kd tripathi; pg num:-214
| 1 |
Colchicine
|
Sulfinpyrazone
|
Naproxen
|
Prednisolone
|
Pharmacology
|
Autacoids
|
de06b2f5-869c-4164-bd32-e0b7467556a3
|
single
|
The following are characteristic of tumour lysis syndrome except -
|
Tumour Lysis Syndrome More common with NHL, Myeloma and acute leukaemia management Rapid tumour cell death releases intracellular contents resulting in hyperkalaemia, hyperphosphataemia, hyperuricaemia and renal failure. Prevention is with adequate hydration and Allopurinol 300-600 mg QID PO Sodium bicarbonate 50 mEq/L IV fluid, Alkalinize the urine above pH 7 to prevent uric acid nephropathy. Indications for dialysis. S. K+ > 6 mEq/L S. Uric acid > 10 mg/dl S. Creatinine > 10 mg/dl S. Phosphate > 10 mg/dl Increasing symptomatic hypocalcaemia. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE 4TH EDITION PAGE NO-757
| 2 |
Hyperkalemia
|
Hypercalcemia
|
Hyperuricemia
|
Hyperphosphatemia
|
Medicine
|
Endocrinology
|
3b9855e8-5d2c-42fe-9beb-3b2eaa4beaf4
|
multi
|
Which of the following interactions contributes most to protein folding
|
Protein folding: *The number of distinct combinations of phi and psi angles specifying potential conformations of even a relatively small-- 15 kDa--polypeptide is unbelievably vast, native conformation is specified in the primary sequence. In nature, protein folding takes place in a more orderly and guided fashion.*Protein folding generally occurs a stepwise process. In the first stage, as the newly synthesized polypeptide emerges from the ribosome, sho segments fold into secondary structural units that provide local regions of organized structure*the hydrophobic regions segregate into the interior of the protein away from the solvent, forming a "molten globule," a paially folded polypeptide*Cells employ auxiliary proteins to speed the process of folding and to guide it toward a productive conclusion*Chaperone proteins paicipate in the folding *The hsp70 (70 kDa heat shock protein) family of chaperones bind sho sequences of hydrophobic amino acids- shielding them from the solvent.*The hsp60 family of chaperones, sometimes called chaperonins, differ in sequence and structure from hsp70 and its homologs. Hsp60 acts later in the folding process, often together with an hsp70 chaperone. The central cavity of the donut-shaped hsp60 chaperone provides a sheltered environment in which a polypeptide can fold until all hydrophobic regions are buried in its interior, thus preempting any tendency toward aggregation.Ref: Harpers Biochemistry; 30th edition
| 3 |
Covalent Bond
|
Ionic interactions
|
Hydrophobic
|
Vander waal's interaction
|
Biochemistry
|
Metabolism of protein and amino acid
|
15a3373f-f276-457d-99ed-dbec6054279f
|
single
|
Receptor of EBV is
|
EBV binds to CD21 or CR2 receptor.
| 2 |
CR1
|
CR2
|
CD20
|
CD19
|
Microbiology
| null |
b04715f9-d7d8-4edd-aeac-09c13d0a4ca5
|
single
|
Non immune hydrops is seen in?
|
Alpha thalassemia major REF: Fetology: diagnosis and management of the fetal patient by Diana W. Bianchi, Timothy Crombleholme, Mary E. D'Alton Page 893, http://en.wikipedia.org/wiki/Hydrops_fetalisImmune_causes Non-Immune causes of Hydrops The non-immune form of hydrops fetalis has many causes including: Iron deficiency anemia Paroxysmal supraventricular tachycardia resulting in Congestive Hea Failure Deficiency of the enzyme beta-glucuronidase (Mucopolysaccharidosis Type VII) Parvovirus B19 (Fifth Disease) infection of the pregnant woman. Maternal syphilis. a thalassemia can also cause hydrops fetalis when all four of the genetic loci for - globin are deleted or affected by mutation. This is termed Hb Bas (consists of y-4 tetramers). Turner Syndrome Tumors, the most common type of fetal tumor being teratoma, paicularly a sacrococcygeal teratoma. Twin-twin transfusion syndrome in monochorionic pregnancy (hydrops affects the recipient twin) Maternal hypehyroidism
| 1 |
Alpha thalassemia major
|
Rh incompatibility
|
Bilateral renal agenesis
|
Maternal rubella
|
Pediatrics
| null |
09111550-20bf-4d2d-9d20-6404f2b2e052
|
single
|
DOC in primary syphillis is –
|
Benzathine penicillin is the drug of choice for primary, secondary, latent and tertiary syphilis (except for neurosyphilis). For neurosyphilis aqueous penicillin G is the drug of choice.
| 3 |
Corticosteroid
|
Oral penicilline
|
Benzathine penicilline
|
Crystalline penicilline
|
Dental
| null |
8db3d3bb-46b7-493d-a700-e342cd389ca5
|
multi
|
Lithium is not used in the treatment of which of the following
|
uses of lithium is impoant it is used in several disorders like vascular headache mania depression drug induced neutropenia suicidal ideas in mania Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 983
| 4 |
Major depression
|
Vascular headache
|
Neutropenia
|
Generalized anxiety disorder
|
Psychiatry
|
Pharmacotherapy in psychiatry
|
ce164c11-db6f-4a13-b8c5-d45962b7662a
|
single
|
About HUS all are true except :
|
Causes mild to severe Coombs positive hemolytic anemia Hemolytic-uremic syndrome (H.U.S.) is the most common cause of acute renal failure in young children. It is classically characterized by the triad of - Microangiopathic hemolytic anemia - Thrombocytopenia - Uremia Etiology Hemolytic uremic syndrome is preceeded by bacterial infections The bacterias commonly associated are : E.coli (Verocytogenic E.coli is the most common ause of hemolytic uremic syndrome) in Nelson states "An acute enteritis with diarrhoae caused by shiga-like toxin producing escherichia coli (verocytogenic E. coli) 0157:117 precedes 80% or more of HUS cases in developed countries" An impoant point Some say that option 'a' was - "Not commonly caused by verocytogenic E.coli in Asia" If this was the option then it is a true statement. - The infection associated with H. U.S. varies with region In developed countires (Noh America and Europe) - Verocytogenic E coli or Shiga like toxin producing Eschererichia coli is the most common cause (80% of all the cases). In Asia (India) - Shigella dysenteriae is the chief pathogen. The anemia associated with hemolytic uremic syndrome is coomb's negative hemolytic anemia. Coomb's positive hemolytic anemia occurs when the anemia is caused due to autoantibodies produced in the body. In H.U.S. the hemolytic anemia is caused by mechanical damage to R.B.C. when they pass through nucrothrombi (which are formed in capillaries due to platelet aggregation). The red cells while passing through these capillaries get attached to the thrombus and gets fragmented causing hemolysis, Autoantibodies have nothing to do with hemolytic uremic syndrome. So the anemia will not be coomb's positive. Thrombocytopenia in H.U.S. A low platelet count can usually but not always be detected early in the illness, but it may then become normal or even high. If a platelet count obtained within 7 days after onset of the acute gastrointestinal illness is not <150,000/mm3, other diagnosis should be considered. Recurrence in H.U.S. Recurrence is rare in H.U.S. There may be disease recurrence only in familial or non diarrhoea associated cases.
| 2 |
Not commonly caused by verocytogenic E coli
|
Causes mild to severe Coombs positive hemolytic anemia
|
Recurrences rare
|
Transient thrombocytopenia
|
Microbiology
| null |
3934108c-b745-4d0c-970c-30779541fceb
|
multi
|
Features of diabetic nonproliferative retinopathy are all except-
|
Diabetic retinopathy is classified into two stages: nonproliferative and proliferative. Nonproliferative diabetic retinopathy usually appears late in the first decade or early in the second decade of the disease and is marked by retinal vascular microaneurysms, blot hemorrhages, and cotton-wool spots (soft exudate). Mild nonproliferative retinopathy may progress to more extensive disease, characterized by changes in venous vessel caliber, intraretinal microvascular abnormalities, and more numerous microaneurysms and hemorrhages.The appearance of neovascularization in response to retinal hypox- emia is the hallmark of proliferative diabetic retinopathy. Reference : page 2424 Harrison's Principles of Internal Medicine 19th edition
| 1 |
Neovascularisation
|
Soft exudates
|
Microaneurysms
|
IRMA
|
Medicine
|
Endocrinology
|
65da98cc-4798-44be-8ee6-5d548629c208
|
multi
|
Anti tobacco day is:-
|
31 may: Anti-tobacco day 1 july: doctor's day 24 march: anti TB day 1 december: World AIDS day
| 3 |
1-Jul
|
24-Mar
|
31-May
|
1-Dec
|
Social & Preventive Medicine
|
Health Schemes
|
aa37a2e2-a3b6-4b67-80da-d0c014d808ec
|
single
|
WHO Malaria Mass Drug Administration ?
|
Ans. is 'b' i.e., >2 First you should know what does mass prophylaxis mean in malaria. o In areas with high malaria prevalence, presumptive treatment is given to all people. This is know as mass treatment. Presumptive treatment is given when API is >2 (see above explanation).
| 2 |
API >5
|
> 2
|
15
|
25
|
Social & Preventive Medicine
| null |
36143579-d330-4098-90ab-8617579fa03a
|
single
|
Which of the following sequence is directed in a retrograde manner to EPR in COP-1 vesicles?
|
KDEL sequence ( lysine - aspaate - glutamate - leucine ) at carboxy terminal first travel to GA in COP-2 vesicles, interact with their specific receptor protein. then they return in a COP-1 vesicle to EPR, get dissociate from their receptor & are retrieved. Reference: Harper; 30th edition
| 1 |
KDEL
|
KDAL
|
DALK
|
KDUL
|
Biochemistry
|
Structure and function of protein
|
76c5b79d-efaa-4820-a365-ec33c2f4cff6
|
single
|
All are been in Pancoast syndrome except
|
Pancoast tumour invades brachial plexus,sympathetic chain,upper ribs,and veebrae.Dyspnoea can occur due to loss of functioning lung tissue/the development of a large pleural effusion.Clubbing and hyperophic pulmonary osteoahropathy can also occur. Bailey & Love's sho practise of surgery,25 th edition,page no:885
| 4 |
Brachial plexus involvement
|
Dyspnoea
|
Clubbing
|
Myasthenia gravis
|
Surgery
|
Cardio thoracic surgery
|
bc719075-445f-4f04-a449-c433c2ea1d06
|
multi
|
Which of the following is not a common cause of vasculitis in adults?
|
Kawasaki disease (mucocutaneous lymph node syndrome) is an aeritis that often involves the coronary aeries (large- to medium-sized vessel aeritis), usually in young children and infants (majority of the cases are seen in <5 years old).
| 3 |
Giant Cell Aeritis
|
Polyaeritis nodosa
|
Kawasaki disease
|
Churg-Strauss syndrome
|
Pathology
|
Vasculitis
|
5e71a731-a5cb-46a7-a451-25783e003bbd
|
single
|
Which of the following is the BEST indicator of ovarian reserve?
|
Measurement of rise in basal FSH is an excellent indicator of ovarian aging. As women age serum FSH concentrations in the early follicular phase begins to increase due to a decline in the number of small follicles secreting inhibin. Day 3 FSH concentration greater than 20 to 25 IU/L is considered to be elevated and is associated with poor reproductive outcome. Measurement of serum E2 levels along with serum FSH adds to the predictive power of an isolated FSH determination. Basal E2 concentration greater than 75 to 80 pg/ml are associated with poor response to ovarian stimulation and pregnancy outcome. Ref: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics By Carl A. Buis
| 1 |
FSH
|
Estradiol
|
LH
|
FSH/LH ratio
|
Gynaecology & Obstetrics
| null |
63452547-c264-400a-8965-239f1a377431
|
single
|
As per WHO, notifiable disease is
|
Cholera Cholera is an acute diarrhoea disease caused by Vibrio cholera Vibrio cholera : 'Gram-negative bacterium' that produces cholera toxin (enterotoxin), which act on C-AMP system of mucosal cells of epithelium lining of the small intestine (to cause massive diarrhoea) Classic biotype El Tor biotype (serotypes: Ogawa , Inaba and Hikojima) Incubation period : 1-2 days (Few hours - 5 days) Reservoir : Human beings only Rice-water diarrhoea Essentials for treatment of cholera : Water and electrolyte replacement (ORS) Guidelines for Cholera control Verification of diagnosis Identifying Vibrio cholerae 01 in stools OF FEW PATIENTS is sufficient. It is not necessary to culture stools of all cases or contacts Notification Cholera is a notifiable disease locally, nationally and internationally Under international Health Regulations, cholera is notifiable to WHO by national Govt Within 24 HOURS (no. Of cases & deaths to be repoed daily and weekly) An area is declared free of cholera when TWICE the OP had elapsed since last case Early case finding: Through aggressive case search Establishment of treatment centres Rehydration therapy : through ORS Adjuncts to therapy : Only antibiotics may be used when vomiting stops Group Antibiotic of choice Treatment Adults Doxycycline Children Azithromycin Pregnancy Azithromycin Chemoprophylaxis Tetracycline Epidemiological investigations : General sanitation measures, epidemiological studies Sanitation measures : Water control, excreta disposal, food sanitation, disinfection Chemoprophylaxis :. Mass chemo prophylaxis I'd not advised for total community ; is only advisable for house hold contacts or a closed community Drug of choice for chemoprophylaxis : Tetracycline. To prevent one case of cholera, 10000 persons need to be given chemoprophylaxis Vaccination Health education Most effective prophylactic measures Ref: park 25th edition Pgno : 247-256
| 1 |
Cholera
|
Malaria
|
Dengue
|
Pneumonia
|
Social & Preventive Medicine
|
Communicable diseases
|
b4f0b993-6a80-4730-9f7c-44462ef553c6
|
single
|
Sensory nerve supply of pinna is:
|
Auriculotemporal nerve, a branch of mandibular nerve (V3) supplies the external acoustic meatus, external surface of auricle above this, skin of temporal region and TM joint.
| 1 |
Mandibular nerve
|
Maxillary nerve
|
Facial nerve
|
Abducent nerve
|
Anatomy
| null |
8b0dae57-2777-488c-8d29-fbfc21b366df
|
single
|
The following tendons pass under extensor retinaculum except
|
RETINACULA:- Around the ankle, the deep fascia is thickened to form bands called retinacula.Front of ankle- superior and inferior extensor retinaculaLateral-superior and inferior peroneal retinacula.Posteromedially- extensor retinacula. Superior extensor retinacula:- Attachments-Medially-lower pa of anterior border of tibia.Laterally- lower pa of anterior border of fibula. Inferior extensor retinacula:- Y shaped band of deep fascia.Attachments-Stem attached to superior surface of calcaneum.Upper band-anterior border of medial malleolus.Lower band-plantar aponeurosis. Structures passing under:-1. Tibialis anterior 2. EHL3. Anterior tibial vessels 4. Deep peroneal nerve.5. EDL6. Peroneus teius. {Reference: BDC 6E pg no.93}
| 4 |
EXTENSOR digitorum brevis
|
Extensor hallucis
|
Tibialis anterior
|
Superficial peroneal nerve
|
Anatomy
|
Lower limb
|
cf327e20-4b17-4c75-93b4-d3600885832b
|
multi
|
Wernicke&;s encephalopathy in alcohol consumption can be treated with
|
Alcohol-Induced Amnestic Disorder: (1) Wernicke's encephalopathy, Confabulation, Ataxia, Ophthalmoplegia (gaze palsy, lateral orbital palsy)horizontal nystagmus tends to reverse rapidly with thiamine supplementation. it can be remebered with a mnemonic GOA G====Global confusion O====ophthalmoplegia A====Ataxia (2) Korsakoff's syndrome (permanent in 50 to 70%): anterograde, retrograde amnesia and potential impairment in visuospatial, abstract, and other types of learning. .They respond to 50 to 100 mg of oral thiamine a day, usually administered for many months. Both are due to thiamine deficiency, causing neuropathological lesions symmetrically in mammillary bodies, thalamus, hypothalamus, midbrain, pons, medulla, fornix, and cerebellum. Reference: P.1279 11.2 Alcohol-Related DisordersKaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Ed
| 2 |
Pyridoxine
|
Thiamine
|
Riboflavin
|
Niacin
|
Psychiatry
|
All India exam
|
3f9d4886-d8c1-4a90-b5a4-3f83d84336cd
|
single
|
Li is best used in -
|
Most important indications of lithium are treatment of acute mania and prophylaxis of bipolar mood disorder, i.e. manic - depressive illness.
| 1 |
MDP - Bipolar
|
MDP - Unipolar
|
MDP - rapid cycles
|
Depression
|
Psychiatry
| null |
d3285acd-aae9-46d7-96ad-0127cd6a3385
|
single
|
A young butcher cuts his forearm with a knife. Over the next week, he notices swelling, redness, and warmth at the site. Four days later, he presents to the emergency depament with fever, shaking chills and severe lower back pain. Physical examination reveals a temperature of 39.4 C (102.9 F), swelling in his forearm with an area of central softness, and tenderness to pressure over his lower spine. Laboratory data show a leukocyte count of 14,000/mm3 with 81% polymorphonuclear leukocytes. Blood cultures grew a gram positive cocci in clusters on blood agar; colonies show a yellow pigment, and the organism is positive on mannitol/salt agar. The organism is catalase and coagulase positive. Which of the following is the most likely pathogen?
|
This organism is a gram positive coccus organized into grape-like clusters. It produces a yellow pigment and the positive mannitol salt agar test showed that it could ferment mannitol and had a high salt tolerance. This organism is catalase positive and coagulase positive, two critical tests for the correct identification of Staphylococcus aureus. Bacteroides fragilis is a gram-negative rod that grows anaerobically. It does cause abscesses, but does not have the characteristics described for the organism in this case. Clostridium perfringens is a gram-positive spore forming organism that causes gangrene. It would not grow aerobically on blood agar. The organism can ceainly spread in the skin when introduced by trauma, but would not demonstrate the biochemical profile described. Escherichia coli is a gram-negative rod that would grow on the blood agar but would not produce yellow pigment. Growth on MacConkey's agar after it was gram-stained would indicate lactose fermentation, and other biochemical tests would be used to specifically identify the organism.
| 4 |
Bacteroides fragilis
|
Clostridium perfringens
|
Escherichia coli
|
Staphylococcus aureus
|
Microbiology
| null |
8c79dfd4-6e97-47b1-9e05-f1218cf46f99
|
single
|
Theophylline levels are increased in all, except
|
Ans. is 'b' i.e., Smoking Smoking induces theophylline metabolism and decreases its plasma level.In certain conditions theophylline concentration is increased, so its dose has to be reduced.These conditions are - Age > 60 years CHFPneumonia Liver failureDrugs causing increased concentration of theophyllineErythromycinCiprofloxacinCimetidineOral contraceptivesAllopurinol
| 2 |
Erythromycin
|
Smoking
|
Cimetidine
|
CHF
|
Pharmacology
|
Asthma
|
4fc04b16-b433-4177-afbe-d711acf90f0c
|
multi
|
Most common Glycogen storage disorder to be present in adolescents is?
|
Mc Ardle disease (Type V GSD) due to muscle phosphorylase deficiency is the most common GSD to present in adolescents & adults.
| 1 |
Mc Ardle disease
|
Cori disease
|
Andersen disease
|
Von Gierke disease
|
Pediatrics
|
Disorders of Carbohydrate Metabolism
|
729cce5d-95f7-4d07-b797-7219ad089f2f
|
single
|
Retinoblastoma is
|
(Autosomal dominant) (280- Khurana 4th)RETINOBLASTOMA - Most common intraocular tumour of childhood and malignant melanoma of choroid in adults*** Identified as band on the long arm of chromosome 13(13ql4)* Most hereditary cases are multifocal* Inheritance is autosomal dominant and the risk of transmitting the gene mutation is 50%* Leukocoria ox yellowish - while pupillary reflex** (also called as amaurotic cat's eye appearance) is the commonest features* In the presence of calcification it gives the typical "Cottage- cheese " appearance* Calcification occurs in 75% is almost pathognomic of Retinoblastoma* Enucleation is the treatment of choice when* Tumour involves more than half of the retina* Optic nerve is involved* Glucoma is present and anterior chamber is involved* External beam radiation therapy spares vision and the cosmetic use of the globe* Palliative therapy (chemotherapy, surgical debulking of the orbit or orbital exentration and External beam radiotherapy (EBRT) is given in following cases where prognosis for life is dismal in spite of aggressive treatment* Retinoblastom with orbital extension* Retinoblastoma with intracranial extension* Retinoblastoma with distant metastasis
| 1 |
Autosomal dominant
|
Autosomal recessive
|
X - linked recessive
|
X- linked dominant
|
Ophthalmology
|
Tumors
|
a5dd40d3-4e6a-46ba-aa8f-29c9eecd4174
|
single
|
Coronary blood flow to the left ventricle increases during all Except
|
During early systole, coronary blood flow falls as coronary vessels are compressed by the contracting myocardium.A fall in PO2 has a potent vasodilator effect on coronary vessels. Adenosine released from hypoxic myocardium is also a potent vasodilator.Sympathetic stimulation increases the rate and force of contraction; the resulting increase in the rate of production of vasodilator metabolites dilates coronary vessels.Myocardial work and metabolism are increased in hypeension.Ref: Guyton; 13th edition
| 1 |
Early systole
|
Myocardial hypoxia
|
Stimulation of sympathetic nerves of the hea
|
Aerial hypeension
|
Physiology
|
General physiology
|
436357a1-aac3-491e-9ebd-afc39be9da7c
|
multi
|
Treatment of choice for asymptomatic pseudocyst pancreas is?
|
ANSWER: (B) ConservativeREF: Sabiston 18th ed chapter 56Recent reports have shown that many pseudocysts eventually resolve without complications. Intervention is not mandatory in all cases unless the pseudocysts areSymptomaticEnlargingAssociated with complications.The likelihood that a pseudocyst will resolve spontaneously, however, is dependent on its size. Large pseudocysts (i.e., >6 cm in diameter) are more likely to become symptomatic either because they are tender or because of their mass effect on adjacent organs Symptomatic or enlarging pseudocysts can be treated by several methods:Those in the tail can be treated by excision (i.e., distal pancreatectomy), but excision in the setting of recent acute inflammation maybe hazardous.Most patients who develop symptomatic pseudocysts are best managed by pseudocyst drainage.In poor surgical risk patients, percutaneous catheter drainage can be considered.Internal drainage can be accomplished either endoscopically (by transpapillary drainage, cystogastrostomy, or cystoduodenostomy) or surgically (by cystogastrostomy, cystoduodenostomy, or Roux-en-Y cystojejunostomy).Pseudocysts that are directly adjacent to either the stomach or duodenum can be safely drained endoscopically if there are no intervening vessels. After endoscopic ultrasound and preliminary aspiration of the cyst fluid to confirm the diagnosis and exclude intervening vessels, endoscopic drainage is achieved by making an incision into the pseudocyst through the wrall of the stomach or duodenum.Transpapillary drainage might be more appropriate for patients with pancreatic head pseudocysts
| 2 |
Marsupialisation
|
Conservative
|
Drainage
|
Cystogastrostomy
|
Surgery
|
Miscellaneous (Pancreas)
|
90caf5e9-2cbf-4899-8299-e66953b15780
|
single
|
Factor which activates prekallikrein -
|
Ans. is 'd' i.e., Factor XIIo Initiation of intrinsic coagulation pathway occurs when factor XII is exposed to negatively charged surfaceo This leads to activation of factor XII to XIIa.o Factor XIIa can then hydrolyze prekallikrein to kallikrein, which in turn activates more XII to XIIa.
| 4 |
Factor VIII
|
Factor II
|
Factor X
|
Factor XII
|
Physiology
|
Blood: Hemostasis and Blood Coagulation
|
249d0064-d3aa-4d68-bd05-c4defaf87d67
|
multi
|
Which one of the following brain tumors is highly vascular in nature?
|
Ans. B. MeningiomasA number of neoplastic lesions in the head and neck area are hypervascular, most commonly meningiomas and hemangioblastoma intra cranially and Paragangliomas and juvenile nasopharyngeal angio fibromas extra cranially.
| 2 |
Glioblastoma.
|
Meningiomas.
|
C P angle epidermoid.
|
Pituitary adenomas.
|
Radiology
|
Nervous System
|
63894812-2c34-4be3-b892-9fca22d92fd6
|
single
|
Preferential expression of same gene depending on parent of origin is referred to as:
|
Genomic imprinting Phenomenon that leads to preferential expression of an allele depending on its, parental origin. Eg : Beckwith Wiedemann syndrome (have two paternal but no maternal copies of chromosome 11). Albright's hereditary osteodystrophy (sho stature, brachydactyly and PTH resistance).
| 1 |
Genomic imprinting
|
Mosaicism
|
Anticipation
|
Non-penetrance
|
Pathology
|
Genetics
|
0fa01198-e176-44f1-a9f0-bab8afac9af4
|
single
|
A 35 years old man presenting with acute pancreatitis. Ideal fluid of choice:
|
Ans. a. Isotonic crystalloidRef: Harrisons Principle of Internal Medicine 19th Ed; Page No-2096Aggressive intravenous fluid resuscitation; is the most important treatment intervention for acute pancreatitis.For rest the pancreas; the patient is made NPO and to control abdominal pain narcotic analgesics given intravenously and supplemental oxygen (2L) via nasal cannula.To maintain urine output>0.5cc/kgper hour; Intravenous fluids of lactated Ringers or normal saline are initially bloused at 15-20cc/kg(1050-1400ml), followed by 3 mg/kg per hour (200-25mL/h).Serial bedside evaluations are required every 6-8 h to asses vital signs, oxygen saturation, and change in physical examination.Lactated Ringers solution may be a better crystalloid than normal saline because it decreases systemic inflammation.
| 1 |
Isotonic crystalloid
|
Hypertonic crystalloid
|
Hypotonic crystalloid
|
Vasopressin
|
Medicine
|
Fluid & Electrolyte
|
56d71743-d367-408e-bc30-87b1c2321151
|
multi
|
In excessive burns, least useful is -
|
We know that Ringer's lactate is the preferred agent during initial 24 hrs.
Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn)
Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid.
Blood has also role in burn patient.
The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary.
Schwartz 9/e p201 writes- "The role of blood transfusion in burns has undergone a re-evaluation in recent years. A large multicenter study found that increased numbers of transfusions were associated with
increased infections and a higher mortality rate in burn patients, even when correcting for burn severity. A follow-up study implanting a restrictive transfusion policy in burned children showed that a hemoglobin threshold of 7 g/dL had no more adverse outcomes versus a traditional transfusion trigger of 10 g/dL.
These data, in concert with other reported complications such as transfusion-related lung injury, have led to recommendations that blood transfusions be used only when there is an apparent physiologic need."
| 1 |
Blood
|
Dextran
|
Ringer lactate
|
Nasogastric intubation
|
Surgery
| null |
af039816-e8b2-4d94-a159-f0a4eeef4e11
|
single
|
Maximum iron absorption occurs in
|
Iron is absorbed from upper small intestine mainly duodenum. In diet, iron occurs in two forms, haem iron and inorganic (non-haem) iron.
Haem iron is better absorbed than inorganic iron, but the major fraction of diet is inorganic iron. Inorganic iron is mostly in ferric form; needs to be reduced to ferrous form because iron is absorbed in ferrous form.
After absorption, ferrous form is once again oxidized to ferric form inside enterocytes.
A fraction of absorbed iron is rapidly delivered to plasma transferrin.
However, most of the iron is deposited in the enterocytes as ferritin,
some to be transferred more slowly to plasma transferrin, and some to be lost when senescent mucosal cells (enterocytes) are sloughed into the intestine.
Iron absorption is regulated according to the demand, e.g., when there is iron deficiency, absorption increases.
This regulation is mediated by “iron metabolism regulatory hormone”, i.e., hepcidin that inhibits iron absorption. When there is iron deficiency, the concentration of hepcidin falls and there is increase iron absorption. Hepcidin also decreases the release of iron from storage sites.
| 1 |
Duodenum
|
Jejunum
|
Ileum
|
Caecum
|
Physiology
| null |
31e5ee87-f9df-407d-9d0a-f6d5f142d344
|
single
|
Eversion occurs at the following joints -
|
Joints taking part in inversion and eversion of foot.
Principal joints- Subtalar, talocalcaneonavicular
Accessory joints- calcaneocuboid, talonavicular
| 1 |
Subtalar
|
Tibiotalar
|
Inferior tibiofibular
|
Ankle
|
Anatomy
| null |
e4985e50-f60c-4e78-bc55-d4aa783699ac
|
single
|
Which is true about Familial hypocalciuric hypercalcemia?
|
Familial hypocalciuric hypercalcemia is an autosomal dominant disorder. Hence choice A is wrong. The mutation in PTH receptor is known as Jansen disease. Hence choice B is wrong. The cause is defective calcium sensing by parathyroid gland leading to excess release of PTH and subsequent hypercalcemia. Urinary reabsorption of calcium is 99% and it presents in the first decade of life. Hence Choice C is wrong. Clinical symptoms are rarely present and hence no treatment is warranted.
| 4 |
Inherited as autosomal recessive pattern
|
Cause is defect in PTH receptor
|
Clinical symptoms occur in third decade
|
Treatment is rarely necessary
|
Medicine
|
Disorders of Parathyroid Gland
|
a36f34e9-872c-410c-88d1-f599dfbcdc98
|
multi
|
Contraindication of rota virus vaccine is -
|
Ans. is 'd' i.e., All of aboveGuide to Contraindications1 and Precautions to Commonly Used VaccinesVaccineContraindicationsPrecautionsHepatitis B (HepB)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero Infant weighing less than 2000 grams (4 lbs, 6.4 oz)Rotavirus(RV5 RV1 )o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Severe combined immunodeficiency (SCID)o History of intussusceptiono Moderate or severe acute illness with or without fevero Altered immunocompetence other than SCIDo Chronic gastrointestinal diseaseo Spina bifida or bladder exstrophyDiphtheria,tetanus, pertussis(DTaP)Tetanus,diphtheria,pertussis (Tdap)Tetanus,diphtheria (DT, Td)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento For pertussis-containing vaccines: encephalopathy (e.g., coma, decreased level of consc iousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of a previous dose of DTP or DTaP (for DTaP); or of previous dose of DTP, DTaP, or Tdap (for Tdap)o Moderate or severe acute illness with or without fevero Guillain-Barre syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccineo Historyr of arthus-type hypersensitivity reactions after a previous dose of tetanus or diphtheria toxoid-containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus-toxoid containing vaccineo For pertussis-containing vaccines: progressive or unstable neurologic disorder (including infantile spasms for DTaP), uncontrolled seizures, or progressive encephalopathy until a treatment regimen has been established and the condition has stabilizedFor DTaP only:o Temperature of 105c F or higher (40.5degC or higher) within 48 hours after vaccination with a previous dose of DTP/DTaPo Collapse or shock-like state (i.e., hypotonic hyporesponsive episode) within 48 hours after receiving a previous dose of DTP/DTaP o Seizure within 3 days after receiving a previous dose of DTP.'DTaPo Persistent, inconsolable crying lasting 3 or more hours within 48 hours after receiving a previous dose of DTP/DTaPHaemophilusinfluenzae type b(Hib)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Age younger than 6 weekso Moderate or severe acute illness with or without feverInactivatedpoliovirus vaccine(IPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyPneumococcal (PCVI3 orPPSV23)o For PCV13, severe allergic reaction (e.g., anaphylaxis) after a previous dose of PCV7 or PCV13 or to a vaccine component, including to any vaccine containing diphtheria toxoido For PPSV23, severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverMeasles, mumps,rubella (MMR)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g.. from hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, or long-term immunosuppressive therapyS or patients with human immunodeficiency virus infection who are severely i mmunocompromi sed) o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Histoiy of thrombocytopenia or thrombocytopenic purpurao Need for tuberculin skin testingY'aricella (Var)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, primary or acquired immunodeficiency, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocomprom i sed)o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valaevclo- vir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccinationHepatitis A(HepA)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverInfluenza, inactivatedinjectable (IIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any IIV or LAIV or to a vaccine component, including egg proteino Moderate or severe acute illness with or without fevero Histoiy of GBS within 6 weeks of previous influenza vaccinationo Persons who experience only hives with exposure to eggs may receive RIV (if age 18-49) or, with additional safety precautions, IIV.Influenza,recombinant (Riffo Severe allergic reaction (e.g., anaphylaxis) after a previous dose of RIV or to a vaccine component. RIV does not contain any egg proteino Moderate or severe acute illness with or without fevero History of GBS within 6 weeks of previous influenza vaccinationInfluenza, liveattenuated(LAIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of IIV or LAIV or to a vaccine component, including egg proteino Conditions for which the ACIP recommend, against use, but which are not contraindications in vaccine package insert: immune suppression, certain chronic medical conditions such as asthma, diabetes, heart or kidney disease, and pregnancyo Moderate or severe acute illness with or without fever o History of GBS within 6 weeks of > previous influenza vaccination o Receipt of specific antivirals (i.e., amantadine, rimantadine, zanamivir, or oseltamivir) 48 hours before vaccination. Avoid use of these antiviral drugs for 14 days after vaccinationHumanPapillomavirus(HPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyMen ingococcal: conjugate (MCV4), polysacch aride (MPSV4)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverZoster (HZV)o Severe allergic reaction (e.g., anaphylaxis) to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocompromised),o Pregnancyo Moderate or severe acute illness with or without fevero Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccination.
| 4 |
SC1D
|
Intussusception
|
Severe allergic raction
|
All of above
|
Pediatrics
|
Viral Infections
|
6921724b-2cf7-411d-9983-e6ebdc055fea
|
multi
|
Lanugo hair first appears in a fetus at: UP 07
|
Ans. 4th month
| 3 |
2nd month
|
3rd month
|
4th month
|
5th month
|
Forensic Medicine
| null |
ba981367-c6e1-4656-b408-c5a43fc39e8d
|
single
|
Leydig cells are derived embryologically from
|
Ans. is 'a' i.e., Mesoderm of gonadal ridge Testosterone producing cells, called leyding cells, develop from mesoderm of the gonadal ridge and are located between sex cords.They produce testosterone by week 8.
| 1 |
Mesoderm of gonadal ridge
|
Endoderm of Genital tubercle
|
Germ cells
|
None of the above
|
Anatomy
| null |
4403de57-9d26-421f-afd8-30f77e3ed47f
|
multi
|
A young female presented with consumption of some substance in the emergency depament. Greenish blue froth was seen coming out of her nostrils and oral cavity. The poisoning is most likely due to which of the following
|
Ans. b. Copper poisoning
| 2 |
Arsenic poisoning
|
Copper poisoning
|
Mercury poisoning
|
Lead poisoning
|
Forensic Medicine
| null |
771d507e-97de-483d-88e6-41e83c507842
|
single
|
In SDS-PAGE (Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis) proteins are separated on basis of:
|
A i.e. Mass
| 1 |
Mass
|
Charge
|
Density
|
None
|
Biochemistry
| null |
0460b56d-7782-45e5-9c0d-2deef051f633
|
multi
|
Most common cause of diarrhea in children of developing countries is:
|
ETEC Most frequent bacterial cause of diarrhea in children of developing countries. Most common cause of traveler's diarrhea. EPEC Cause infantile diarrhea (outbreaks) Rarely sporadic diarrhea in adults.
| 2 |
EHEC
|
ETEC
|
EAEC
|
EIEC
|
Microbiology
|
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
|
147c7014-1a91-4c8d-b4bf-ebf9dd65d7d5
|
single
|
Secondary vesical calculus refers to stones formed due to:
|
• Most vesical calculi are formed de novo within the bladder, but some initially may have formed within the kidneys as a dissociated Randall plaque or on a sloughed papilla and subsequently may have passed into the bladder, where additional deposition of crystals cause the stone to grow.
• Most renal stones that are small enough to pass through the ureters are also small enough to pass through a normally functioning bladder and an unobstructed urethra.
• In older men with bladder stones composed of uric acid, the stone most likely formed in the bladder.
• Stones composed of calcium oxalate are usually initially formed in the kidney.
• In adults, MC type of vesical stone (seen in >50% of cases) is composed of uric acid.
• Less frequently, bladder calculi are composed of calcium oxalate, calcium phosphate, ammonium urate, cystine, or magnesium ammonium phosphate (when associated with infection).
Endemic Bladder Calculi
• In children, stones are composed mainly of ammonium acid urate, calcium oxalate, or an impure mixture of ammonium acid urate and calcium oxalate with calcium phosphate.
• The common link among endemic areas relates to feeding infants human breast milk and polished rice.
• These foods are low in phosphorus, ultimately leading to high ammonia excretion.
• These children also usually have a high intake of oxalate-rich vegetables (increased oxalate crystalluria) and animal protein (low dietary citrate).
• Vesical calculi may be single or multiple, especially in the presence of bladder diverticula, and can be small or large enough to occupy the entire bladder. They range from soft to extremely hard, with surfaces ranging from smooth and faceted to jagged and spiculated (“jack” stones).
• Most bladder stones are secondary, more common in older males (>50 years), usually because of bladder outlet obstruction.
• MC type: Uric acid (sterile urine) > Struvite stones (Infected urine)
• Bladder stones are usually solitary, multiple in 25% patients.
Etiology
• Bladder outlet obstruction (MC cause)
• Neurogenic bladder
• Foreign body (Foley’s catheter, forgotten DJ stents)
• Bladder diverticula
Clinical Features
• Typical symptoms are intermittent, painful voiding and terminal hematuria with severe pain at the end of micturition.
• Pain may be referred to the tip of the penis or to the labia majora.
Diagnosis
• A large percentage of bladder stones are radiolucent (uric acid).
• USG bladder: Identifies the stone with its characteristic shadowing and stone moves with changing body position.
Treatment
• Small stones: Removed or crushed transurethrally (Cystolitholapexy)
• Larger stones: Disintegrated by transurethral electrohydraulic lithotripsy or Cystolithotomy
Stones of Genitourinary Tract
• MC renal stone: Calcium oxalate
• MC primary bladder stone: Ammonium urate
• MC bladder stone: Uric acid >Struvite
• MC prostate stone: Calcium phosphate
| 3 |
Hypercalciuria
|
Injury
|
Infection
|
Migrating from above
|
Surgery
| null |
6619c233-c87e-4b2e-852a-2d93b65ab07c
|
multi
|
Alpha agonist has all of the following actions except: September 2009
|
Ans. C: General Anesthesia Alpha-adrenoceptor agonists bind to alpha-receptors on vascular smooth muscle and induce smooth contraction and vasoconstriction, thus mimicking the effects of sympathetic adrenergic nerve activation to the blood vessels. Vascular smooth muscle has two types of alpha-adrenoceptors: alphal and alpha2. The alphal-adrenoceptors are the predominant alpha-receptor located on vascular smooth muscle. Depending on the tissue and type of vessel, there are also alpha2-adrenoceptors found on the smooth muscle. There are also alpha2-adrenoceptors located on the sympathetic nerve terminals that inhibit the release of norepinephrine and therefore act as a feedback mechanism for modulating the release of norepinephrine. Alpha-agonists constrict both aeries and veins; however, the vasoconstrictor effect is more pronounced in the aerial resistance vessels (small aeries and aerioles). Alphal-adrenoceptor agonists (systemic vasoconstrictors) Methoxamine Phenylephrine Oxymetazoline Tetrahydralazine Xylometazoline Methoxamine and phenylephrine are used as pressor agents in treating hypotension and shock. Oxymetazoline, tetrahydralazine, xylometazoline and some preparations of phenylephrine are used as nasal decongestants. Alpha2-adrenoceptor agonists (centrally-acting vasodilators) Clonidine Guanabenz Guanfacine Alpha-methyldopa The alpha2-adrenoceptor agonists are used very occasionally as centrally-acting sympatholytic vasodilators for the treatment of hypeension.
| 3 |
Hypotension
|
Hypeension
|
General anesthesia
|
Nasal decongestant
|
Pharmacology
| null |
2f358574-f845-4f07-8b9e-047243734a3c
|
multi
|
A newborn with respiratory distress with RR 86/ min, nasal flaring, audible grunting, abdomen lagged behind chest respiratory movement, no lower chest or xiphoid retraction. What is silverman's score –
| null | 3 |
1
|
3
|
5
|
6
|
Pediatrics
| null |
d10447da-eefd-4163-83f2-23f41bc8ea3d
|
single
|
Giant cells seen
|
Giant cell tumors of bone also known as osteoclastomas are relatively common bone tumors, usually benign which are arising from metaphsis and typically extending into epiphysis of the long bones. Young adults of ages 20-40 are more prone to these conditions. In a x ray we can find soap bubble appearance . >aicles > REF OF IMG:
| 1 |
Osteoclastoma
|
Chondroblastoma
|
Chordoma
|
Osteitis fibrosa cystisca
|
Pathology
|
Breast
|
216b722c-01cb-4032-be2e-32fbfdf9beb2
|
single
|
Enlarged corneal nerves may be seen in all of the following except:
|
Enlarged corneal nerves not seen in Herpes simplex keratitis. Ref:Color Atlas of Ophthalmology: The Quick-Reference Manual for Diagnosis and Treatment By Amar Agarwal, Soosan Jacob, 2009, Page 191
| 2 |
Keratoconus
|
Herpes simplex keratitis
|
Leprosy
|
Neurofibromatosis
|
Ophthalmology
| null |
e9a18738-14c1-4f3d-a9b7-415b497bc915
|
multi
|
Coverings of graffian follicle are all EXCEPT:
|
ANSWER: (C) Germinal cellsREF: Ganong s 22nd ed chapter 23Coverings of the mature or graffian follicle are (From inner to outer)Innermost the Granulosa cellsThe theca internaThe theca externa
| 3 |
Theca externa
|
Theca interna
|
Germinal cells
|
Granulosa cells
|
Anatomy
|
Female Sex Glands
|
2ce4678b-321d-43e7-ad3a-432f56d4df11
|
multi
|
A conceptus material (foetus) was found by police has been brought of 4 cm length and 10 gm weight. What is the age?
|
Age of foetus is calculated by 'Rule of Haase'. The length of the foetus is measured from the crown to the heel in centimetres. During the first five months of pregnancy the square root of the length gives the approximate age of the foetus in months. During the last five months, the length in cm divided by five gives the age in months. Here, the length of foetus is 4 cm. Hence the age will be 2 months (8 weeks). Ref: The Essentials of Forensic Medicine and Toxicology by K S Reddy, 27th edition, Page 74-75.
| 4 |
2 weeks
|
4 weeks
|
5 weeks
|
8 weeks
|
Forensic Medicine
| null |
57cf409d-f454-4be6-b829-89354b46fb2b
|
single
|
All of the following are true about regional blood flow in pregnancy except :
|
REGIONAL DISTRIBUTION OF BLOOD FLOW: Uterine blood flow is increased from 50 mL/min in non-pregnant state to about 750 mL near term. The increase is due to the combined effect of uteroplacental and fetoplacental vasodilatation. The vasodilatation is due to the smooth muscle relaxing effects of progesterone, estrogen, nitric oxide (endothelium derived factor), prostaglandins and atrial natriuretic peptide (ANP). In a normal pregnancy, vascular system becomes refractory to angiotensin II, endothelin I and other pressure agents. Pulmonary blood flow (normal 6000 mL/min) is increased by 2500 mL/min. Renal blood flow (normal 800 mL) increases by 400 mL/min at 16th week and remains at this level till term. The blood flow through the skin and mucous membranes reaches a maximum of 500 mL/min by 36th week. Heat sensation, sweating or stuffy nose in pregnant woman is thus explained. Reference: Dutta's Textbook of Obstetrics 7th edition page no 54
| 2 |
Uterine blood flow at term is 750 ml/min
|
Blood flow through skin decreases
|
Renal blood flow increases by 50%
|
Pulmonary blood flow increase
|
Gynaecology & Obstetrics
|
General obstetrics
|
a5bf372b-b113-46e2-83a3-fc97c75b23cb
|
multi
|
All of the statements about quarantine are true except
|
Quarantine is defined as the limitation of freedom of movement of such well persons or domestic animals exposed to communicable disease for a period of time not longer than the longest usual incubation period of the disease in such manner as to prevent effective contact with those not exposed. In contrast to isolation, quarantine applies restrictions on the healthy contact of an infectious disease (refer pgno:121 park 23 rd edition)
| 1 |
It is synonymous with isolation
|
Absolute quarantine is restriction during the incubation period
|
Exclusion of children from schools is an example of modified quarantine
|
Quarantine should not be longer than the longest incubation period
|
Social & Preventive Medicine
|
Epidemiology
|
838ebcf5-956a-4205-bbcc-56fa7b96201e
|
multi
|
All of the following are superficial muscles of the back, EXCEPT?
|
Trapezius, levator scapulae, rhomboid major, rhomboid minor, and latissimus dorsi constitute the superficial muscles of the back. Erector spinae, splenius, transversospinalis, and suboccipital muscles constitute the deep muscles of the back. Erector spinae muscle:Iliocostalis, longissimus, and the spinalis muscles together constitute the erector spinae muscle.When it acts bilaterally it helps in extending the veebral column.When acting unilaterally it laterally flex the veebral column and rotate it to the ipsilateral side.
| 2 |
Trapezius
|
Erector spinae
|
Latissimus dorsi
|
Levator scapulae
|
Anatomy
| null |
c864154e-5705-4fb5-99f2-c1ef3b781e32
|
multi
|
The daily recommended dose of the fluoride for the children below 3 years is
| null | 1 |
Less or equal to 0.5 mg
|
0.5 to 0.7 mg
|
1.0 to 1.5 mg
|
None of the above
|
Dental
| null |
a99a3307-1c39-4fe5-8990-91d6001c631a
|
multi
|
ICD - 10 code in XXI includes all except
|
Chapter XXI includes factors influencing health status and contact with health services Ref : Park&;s textbook of preventive and social medicine; 23rd edition - page no 50
| 3 |
Lack of exercise
|
Alcoholism
|
Poisoning
|
Unhealthy found
|
Social & Preventive Medicine
|
Concept of health and disease
|
c070e0ab-af56-46e8-aea1-2ada53854ac6
|
multi
|
In classic Barret's, the length of columnar epithelium in distal oesophagus is
|
Classic Barrett's (>= 3cm columnar epithelium);Sho-segment Barrett's (<3 cm of columnar epithelium);Cardia metaplasia (intestinal metaplasia at the oesophagogastric junction without any macroscopic change at endoscopy).The relative risk of cancer rises with increasing length of abnormal mucosa.
| 3 |
>1cm
|
>2cm
|
>3cm
|
>4cm
|
Surgery
|
G.I.T
|
48e3bfd0-de65-4387-8426-ae2a954c87c3
|
single
|
Carcinoma cervix is associated with all except :
|
Diabetes mellitus
| 4 |
Multipay
|
Herpes simplex virus
|
Early coitus
|
Diabetes mellitus
|
Gynaecology & Obstetrics
| null |
9456f3e1-6058-4996-80b3-5bce8d22629a
|
multi
|
Apheresis platelet donation--true is all except:
|
Ans. A.A person with below normal platelet count can donateExplanationSpecific Eligibility Criteria for Apheresis Platelet DonorsAge: 18-60 years and Weight- 50 kg (This is not just for platelet donation but also for all blood and blood product donations in India)Donor platelet count must be > 1,50,000/dL (Option a)If taking anti-platelet medication:Aspirin- defer for at least 2 full medication-free daysClopidogrel or ticlopidine - defer for at least 14 full medication-free daysFrequency of donations:Can donate up to 2 times in a week (Option c)24 times in a year (Option d)Minimum interval between donationsMinimum of a 48 hour-interval needed after donating single unit (Option b)7 days after donating double or triple units.Other important points about platelet transfusionThreshold for prophylactic platelet transfusion is 10,000/mL.In patients without fever or infections, a threshold of 5000/mL may be sufficient to prevent spontaneous hemorrhage.For invasive procedures, the usual target level is 50,000/mL platelets.Platelets are produced in two ways:Random donor (RD) platelets: Whole blood donations are centrifuged and the buffy coats (between the red cell and plasma layers) from four donations are pooled in the plasma of one of the donors.Single donor apheresis platelets (SDAP): Platelets are obtained from a single donor by apheresis. SDAP contain the equivalent of at least 6 units of RD platelets and have fewer contaminating leukocytes than pooled RD platelets.Time required in collecting SDAP is 2 to 3 hours (in RD its 30 mins).Storage--20-24degC with agitationShelf life--5 days (7 days if bacterial screening)
| 1 |
A person with below normal platelet count can donate
|
Person can donate again after 2 days
|
Person can donate 2 times maximum in a week
|
Not more than 24 donations can be done in 1 year
|
Medicine
|
Blood
|
a0f2ae1d-1f87-4661-a223-f29df7e0986d
|
multi
|
Color of hemosiderin is?
|
Ans. (b) Brown(Ref: Robbins 9th/pg 64; 8th/pg 36-38)Hemosiderin is yellowish-brown granular pigment formed from breakdown of Hb in RE cells; composed of ferritin complex.
| 2 |
Black
|
Brown
|
Blue
|
Yellow
|
Pathology
|
Misc. (R.B.C)
|
df7afaaa-5f9f-426c-91d0-4f5a67962e0e
|
single
|
A perception experienced in the absence of an external stimulus in clear consciousness is:
|
Ans. B. Hallucination3 criteria are essential for definition of hallucination:(A) Percept-like experience in the absence of an external stimulus;(B) Percept-like experience that has the full force and impact of a real perception; and(C) Percept-like experience that is unwilled, occurs spontaneously, and cannot be readily controlled by the percipient
| 2 |
Delusion
|
Hallucination
|
Illusion
|
Pseudohallucination
|
Psychiatry
|
Symptoms & Signs
|
c4e3f0df-f408-41be-8f48-51f894f4b4b8
|
multi
|
Which of the following adverse effects is most likely to occur with sulfonamides ?
| null | 4 |
Neurologic effects including headache, dizziness, and lethargy
|
Hematuria
|
Fanconi's anemia
|
Skin reactions
|
Pharmacology
| null |
be2037e5-63be-48be-838e-ffabac01370e
|
single
|
Therapeutic drug monitoring is used in -
|
Ans. is 'd' i.e., Digoxin Therapeutic drug monitoring is particularly useful in following situations -1. Drugs with low safety margin -a) Digoxinb) Anticonvulsantsc) A ntiarryth micsd) Theophyllinee) Aminoglycoside antibioticsf) Lithiumg) Tricyclic antidepressants2. If individual variations are large - Antidepressants, Lithium3. Potentially toxic drugs used in presence of renal failure - Aminoglycoside antibiotic, vancomycin, cyclosporine4. In case of poisoning5. In case of failure of response without any apparent reason - Antimicrobials6. To check patient compliance - Psycho-pharmacological agents.o Drugs whose response is easily measurable eg. hvpoglycaemics (metformin), antihypertensive, diuretics, oral anticoagulants and general anaesthetics, monitoring of plasma cone, is of no value.
| 4 |
Diuretic
|
Metformin
|
Levodopa
|
Digoxin
|
Pharmacology
|
Pharmacodynamics
|
0cd7f23b-1b26-481d-afa7-9a1763e220a9
|
single
|
Which of the following is the allosteric activator of carbamoyl phosphate synthase I?
|
Carbamoyl phosphate synthase I is the rate-limiting enzyme of the urea cycle Active only in the presence of N-acetylglutamate(NAG), an allosteric activator that enhances the affinity of the synthase for ATP. Arginine is the allosteric activator of NAG synthase.
| 4 |
Glutamine
|
Oxaloacetate
|
N-acetyl aspaate
|
N-acetyl glutamate
|
Biochemistry
|
Urea cycle
|
4d59a8b5-8aa0-4977-b59b-19a504aed7d8
|
multi
|
Sistrunk's operation is used ina) Parotid tumourb) Thyroglossal fistulac) Thyroglossal cystd) Branchial fistula
|
Thyroglossal Cyst Cystic swelling developed in the remnant of the thyroglossal duct or tract Present in any pa of the thyroglossal tract (extends from foramen caecum to isthmus of thyroid) Common sites Subhyoid (MC) Floor of mouth Region of thyroid cailage Suprahyoid Beneath the foramen caecum Clinical features It is a midline swelling, except in the region of thyroid cailage, where thyroglossal tract is pushed to one side, usually to the left Though its a congenital swelling MC age of presentation is between 15 and 30 years Cyst can be moved sideways but not veically Peculiar characteristics which helps in distinguishing thyroglossal cyst from other neck swelling Moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue Moves with deglutition so do all thyroid swellings, subhyoid bursitis Cyst is lined by pseudostratified columnar epithelium and squamous epithelium with hetero topic thyroid tissue present in 20% of cases Complications Recurrent infections Formation of thyroglossal fistula Carcinomatous change (papillary carcinoma) Treatment Sistrunk operation : En-bloc cystectomy and excision of central hyoid bone to minimize recurrence Ref: Sabiston 20th edition Pgno :1861
| 2 |
c
|
bc
|
abd
|
cd
|
Anatomy
|
Head and neck
|
8c91ab4c-1d7c-44c8-a77a-6d12aefacba3
|
single
|
An old man was brought to OP by his son telling that his father is having habit of washing his hands 'n' number of times and repetition of other daily routines as well. Characteristic of obsession are all, EXCEPT:
|
According to the DSM-IV, obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions or compulsions that are ego-dystonic and time-consuming and that interfere with normal functioning. Compulsions or compulsive behavior may result when patients engage in repetitive behavior in an attempt to reduce anxiety or cope with these obsessive thoughts. Obsessions refer to thoughts, ideas, or images which recur and are distressing or unwanted. Ref: Handbook of Neuropsychology and Aging edited by Paul David Nussbaum, 1997, Page 83.
| 2 |
Repetitive behavior
|
Repetitive behavior
|
Ego dystonic
|
Compulsion
|
Psychiatry
| null |
f1c3475f-429c-4697-8f38-ae1ceaf399cc
|
multi
|
All are true about selenocystiene EXCEPT:
|
Selenocysteine is found in approximately 25 human proteins. Enzymes which use selenocysteine at their active sites are known as Selenoproteins e.g. 1. Glutathione peroxidase 2. Thioredoxinreductase 3. Iodothyroninedeiodinase Precursor amino acid for selenocysteine is serine. (not cysteine or methionine) Coded by UGA codon
| 4 |
Considered as 21stAmino acid
|
Coded by UGA
|
Occurs in glutathione peroxidase
|
Made of cysteine and methionine
|
Biochemistry
|
Classification and metabolism of amino acids
|
257a5ee8-b6c6-4920-b23a-ee272608f82c
|
multi
|
All true about airway management in obese patient except:-
|
Airway management in obese Excess fatty tissue tends to make access (intubation, tracheostomy) worse than in lean patients. Proper planning and preparation of airway management is essential: Elevation of the patient's upper body, head and neck. Preoxygenation is mandatory in morbidly obese patients and should be followed by actions to counteract atelectasis formation. Use a rapid sequence induction, an awake intubation or a standard induction with hypnotics should depend on the thorough airway examination and comorbidity and should not be based solely on whether morbid obesity is present or not. Ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. Intubating laryngeal mask airway is more efficient in the morbidly obese patients than in lean patients and serves as a rescue device for both failed ventilation and failed intubation. In the 24 h following anaesthesia, morbidly obese patients experience frequent oxygen desaturation periods that can be counteracted by continuous positive airway pressure, noninvasive ventilation and physiotherapy.
| 3 |
Pre oxygenation is preferred in obese patients
|
Positioning for laryngoscopy is these patients preferred is stacking
|
Awake intubation is mode of choice in morbidily obese patients
|
Patient with history of Obstructive Sleep Apnea are candidates for difficult airway
|
Anaesthesia
|
Intravenous Anesthetic Agents
|
4d5327e7-6aad-45d7-b0e2-a19e2e2bf87e
|
multi
|
Tone decay test is done for:
|
(b) Neural deafness(Ref. Anirban Biswas, 5th ed. 56)Tone decay is a function of nerve fatigue.If the nerves are fatigued the patient stops hearing a sound given to him continuously before the completion of 1 minute.A tone decay of more than 30dB is suggestive of retrocochlear or neural deafness
| 2 |
Cochlear deafness
|
Neural deafness
|
Middle ear problem
|
Otosclerosis
|
ENT
|
General
|
a2ce4a6c-644e-41de-beb6-b494b9c41bd0
|
single
|
Most common cause of cushings syndrome is
|
Most common cause of Cushing's syndrome is prolonged administration of glucocorticoid harmones.
| 4 |
Pituitary adenoma
|
Adrenal adenoma
|
Ectopic ACTH
|
Iatrogenic steroids
|
Pediatrics
| null |
86ee4636-cfaf-48e3-8505-b95fa2b951d6
|
single
|
Which of the following oncogenes is a growth factor?
|
The 'sis' oncogene is a growth factor. The protooncogene 'sis' encodes the ( b chain of) Platelet Derived Growth Factor (PDGF). Ref: Robbin's Illustrated Pathology, 7th Edition, Pages 293, 295; Cancer: Principles and Practice of Oncology, 6th Edition, Page 13
| 4 |
fos
|
myc
|
jun
|
sis
|
Pathology
| null |
7bb22797-974c-46d5-be36-e8ee6a7d0aba
|
single
|
The 'heel effect' results
| null | 3 |
In low intensity X-ray beam on anode side of central ray
|
In high intensity beam of X-rays towards cathode
|
Both of them are true
|
None of the above are true
|
Radiology
| null |
328226c9-ec59-4957-8300-8f58e08e2c51
|
multi
|
OVAL cells seen in stem cells of-
|
oval cells - canal of herring of the liver limbus cells - canal of schlemm (stem cell for the cornea) epidermal stem cell in the skin bone marrow stromal stem cell - fat,cailage,bone ref robbins pathology 9th ed page 28
| 3 |
Skin
|
Cornea
|
Liver
|
Bone
|
Pathology
|
General pathology
|
46326475-f3ed-48a3-b8ac-926420a25eb8
|
single
|
"Magical thinking" is characteristically seen in
|
(C) Schizotypal personality # SCHIZOTYPAL PERSONALITY DISORDER (STPD) is a personality disorder characterized by a need for social isolation, anxiety in social situations, odd behavior and thinking, and often unconventional beliefs.> Characterised by eccentric behaviour, Poor rapport, Odd beliefs or magical thinking, Suspiciousness or paranoid ideas, delusion-like ideas, usually occurring without external provocation.> Treatment is almost like Shizophrenia including Neuroleptics, thixenthenes, SSRI's.> Schizotypal patients who are more obsessive-compulsive in their beliefs and behaviors - in this case SSRIs, e.g. fluoxetine, appear to be more effective.
| 3 |
Shizophrenia
|
Obsessive Compulsive Disorder
|
Schizotypal personality
|
Anxiety disorder
|
Psychiatry
|
Miscellaneous
|
14704711-902e-4dd7-8084-7fd940cf59a9
|
multi
|
Creatinine kinase is elevated in MI after
|
CK-MB remains a valuable marker of myocardial injury, second only to the cardiac-specific troponins . Total CK activity is not a reliable marker of cardiac injury since various isoforms of CK are also found in brain, myocardium, and skeletal muscle. However, the CK-MB isoform--principally derived from myocardium, but also present at low levels in skeletal muscle--is the more specific indicator of hea damage. CK-MB activity begins to rise within 2 to 4 hours of MI, peaks at 24 to 48 hours, and returns to normal within approximately 72 hours. (Robbins Basic pathology,9th edition.pg no.382)
| 1 |
2-4hrs
|
4-8hrs.
|
12-24hrs
|
>24hrs.
|
Pathology
|
Cardiovascular system
|
e5e1b67f-1a7e-4d40-afdf-9c844662e438
|
single
|
Idiopathic nephrotic syndrome is associated with the following except:
|
Ans. D. Mesangioproliferative glomerulonephritis. (Ref. Robbin's Pathology8th/pg. Table 14-2)Membranoproliferative GN (MPGN) is manifested histologically by alterations in the GBM and mesangium and by proliferation of glomerular cells. It accounts for 5% to 10% of cases of idiopathic nephrotic syndrome in children and adults. Some individuals present only with hematuria or proteinuria in the non-nephrotic range; others have a combined nephrotic-nephritic picture. Two major types of MPGN (I and II) are recognized on the basis of distinct ultrastructural, immunofluorescence microscopic, and pathogenic findings. Of the two types, type I is far more common (~ 80% of cases).The Nephrotic Syndrome# The nephrotic syndrome is characterized by proteinuria, which results in hypoalbuminemia and edema. Podocyte injury is an underlying mechanism of proteinuria, and may be the result of nonimmune causes (as in MCD and FSGS) or immune mechanisms (Membranoproliferative variety).# Minimal change disease (MCD) is the most frequent cause of nephrotic syndrome in children; it is manifested by proteinuria and effacement of glomerular foot processes without antibody deposits; the pathogenesis is unknown; the disease responds well to steroid therapy.# Focal and segmental glomerulosclerosis (FSGS) may be primary (podocyte injury by unknown mechanisms) or secondary (e.g. as a consequence of prior glomerulonephritis, hypertension or infection such as HIV); glomeruli show focal obliteration of capillary lumens, hyaline deposits and loss of foot processes; the disease is often resistant to therapy and may progress to end stage renal disease.# Membranous nephropathy (MN) is caused by an autoimmune response against an unknown renal antigen; it is characterized by granular subepithelial deposits of antibodies with GBM thickening and loss of foot processes but little or no inflammation; the disease is often resistant to steroid therapy.Causes of Nephrotic Syndrome: CauseChildren-Prevalence (%)Adults-Prevalence (%)A.Primary Glomerular Disease 1Membranous GN5302Minimal-change diseaseQ65103Focal segmental glomerulosclerosisQ10354Membranoproliferative GNQ10105IgA nephropathy and others1015B.Systemic Diseases with Renal Manifestations1Diabetes mellitusNote:Approximate prevalence of primary disease is 95% of the cases in children, 60% in adults.Approximate prevalence of systemic disease is 5% of the cases in children, 40% in adults.2Amyloidosis3Systemic lupus erythematosus4Ingestion of drugs (gold, penicillamine, "street heroin")5Infections (malaria, syphilis, hepatitis B, HIV)6Malignancy (carcinoma, melanoma)7Miscellaneous (bee-sting allergy, hereditary nephritis)
| 4 |
Focal Segmental glomerulosclerosis
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Minimal Change Disease
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Membranoproliferative glomerulonephritis
|
Mesangioproliferative glomerulonephritis
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Pathology
|
Kidney
|
87a303df-6a2e-404b-9678-c0e2eaf1beea
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multi
|
True statement regarding follicular cell carcinoma of thyroid:
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(Refer: Robbins Pathologic Basis of Disease, 8thedition, pg no: 1120-1124)
Histological variants of Thyroid Carcinoma
| 1 |
Hematogenous spread
|
Commonly multifocal
|
Readily diagnosed by FNAC
|
Most common carcinoma of thyroid
|
Unknown
| null |
7c9cf0b1-4114-40b4-9fce-8410b1e40fcb
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multi
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Transperitoneal approach to repair genitourinary fistula is used in all situations except
|
Transperitoneal approach of repair is preferred in complex large fistulas.
| 4 |
Fistula closer to ureteral orifices.
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Con-comitant ureteric and vesicovaginal fistula.
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Fistula located proximally in a narrow vagina.
|
Non-complicated small vesicovaginal fistula.
|
Gynaecology & Obstetrics
| null |
d0a542e3-5d0f-4a1d-b278-0f8e48afc6e8
|
multi
|
Vitamin D
| null | 4 |
Absorption requires bile pigments
|
Synthesis is regulated at the reaction catalyzed by 15-hydroxylase
|
Deficiency on adults leads to rickets
|
Along with PTH, increases calcium resorption from bone
|
Biochemistry
| null |
ebeb0624-478f-4594-9968-da2a78b87a89
|
single
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A 22 year old man presents with history of bleeding from gums for the last 6 months. On investigation the b was found to be 8.2 gm% TLC 4400/mm, DLC N 64%, L 27%, E 3%, M 6% and platelet count of 20,000 /cu mm. Which one of the following investigation would be most useful in establishing the diagnosis -
| null | 4 |
Bleeding time and clotting time
|
Prothrombin time
|
Partial thromboplastin time
|
Bone marrow examination
|
Medicine
| null |
625771fb-b4fb-436c-b66a-b24fe8311fd9
|
single
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Pheochromocytoma with malignant potential exclusively secretes
| null | 1 |
Dopamine
|
Epinephrine
|
Metanephrine
|
Norepinephrine
|
Surgery
| null |
790987c0-aba4-41b4-b021-e22743b2b94d
|
single
|
All the following statements about lobular carcinoma of breast are true EXCEPT:
|
Ans) a (Easily...) Ref: Sabiston 18th ed, 17th ed p890, Robbins 7th ed p 1144Invasive lobular carcinoma (ILC) may be found by mammography, However, ILCdoes not always show up well on a mammogram because of the cells' tendency to grow in a single-file line, rather than form a mass. If mammogram does find invasive lobular carcinoma, the tumor may appear smaller than it actually is. Whenever a screening mammogram highlights an area of concern, additional mammograms often will be done to gather more information about that area. Mammography will be performed on both breasts. So ILC is difficult to detect in mammogram.Infiltrating lobular carcinomaInfiltrating lobular carcinoma accounts for about 5 percent of all malignant invasive cancers. It occurs most frequently in women between the ages of 45 and 56. The tumor grows in the terminal (last part) of the lobules where milk is produced. It usually does not show up on mammography and may feel like a thickening in the upper-outer quarter of the breast (from the nipple to under the arm) as it infiltrates the walls of the lobules.In about 30% of cases, this cancer is frequently found in the opposite breast.It is often found in other parts of the same breast (multicentric).Most tumors are positive for estrogen and progesterone receptors and thus respond well to hormonal therapy.Infiltrating lobular carcinoma sometimes has an increased incidence of spreading to the uterus and ovaries.Lobular carcinoma in situ (LCIS) occurs bilaterally in 50 70% of cases, while ductal carcinoma in situ (DCIS) occurs bilaterally in 10 - 20% of cases.Invasive lobular carcinomaFrequently multifocal, multicentric and bilateral.Incidence increased in post menopausal women (related to post menopausal HRT)Histological hallmark - pattern of single infiltrating tumor cells, often only one cell in width (Indian File Pattern) or in loose clusters or sheets.Most lobular carcinoma show a loss of a region on chromosome 16 (e-cadherin and b catenin genes are lost)Lobular carcinoma have a different pattern of metastasis compared to other breast carcinoma (less likely to metastasis to lung and pleura)Well/moderately differentiated lobular carcinomaDiploidExpress hormone receptorsAssociated with LCIS in majority of casesHER 2/neu over expression is very rare.Poorly differentiated lobular carcinomaAneuploidOften lack hormone receptorsMay over express HER 2/neuUltrasound bounces sound waves off of the breast to create additional images of the tissue. Ultrasound can be used in addition to mammography. Ultrasound appears to be more accurate in detecting invasive lobular carcinoma than mammography. As with mammography, however, the tumor may appear smaller than it is.Note:Breast carcinoma with good prognosis even with axillary lymph nodes - medullary CaBulls eye appearance is seen in - invasive lobularDesmoplastic reaction is shown by - ductalComedo carcinoma is - ductal carcinoma in situ (DCIS)Most common variant of breast carcinoma - Ductal invasive
| 1 |
Easily detectable in mammography
|
30% bilateral
|
Lobectomy is less preferred
|
Difficult to detect in mammography.
|
Surgery
|
Breast Cancer - Types and Staging
|
ac24c246-0769-45e4-bfea-1b097a2a58ca
|
multi
|
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